Individual provider Active NPI

Devin Kelly, LSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1750003364
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.109056 Issued in IL
Practice address
3323 W Diversey Ave # 16
Chicago, IL 60647-8582
Phone
(773) 219-3900
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.109056 IL Primary

Addresses

Primary practice location

3323 W Diversey Ave # 16
Chicago, IL 60647-8582

Mailing address

3323 W Diversey Ave # 16
Chicago, IL 60647-8582
Phone (773) 219-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260625003342 IL Practitioner - Clinical Social Worker 2567934771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3323 W Diversey Ave
Suite 16
Chicago, IL 60647-8582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.109056ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Subtle Shifts Chicago, PLLC Current Accepting new patients

Locations

3323 W Diversey Ave
#16
Chicago, IL 60647
Phone (773) 213-3900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1750003364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3323 W DIVERSEY AVE # 16",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606478582",
            "telephone_number": "773-219-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3323 W DIVERSEY AVE # 16",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606478582",
            "telephone_number": "773-219-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DEVIN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.109056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.